K. Howorka et al., OPTIMAL PARAMETERS OF SHORT-TERM HEART-RATE SPECTROGRAM FOR ROUTINE EVALUATION OF DIABETIC CARDIOVASCULAR AUTONOMIC NEUROPATHY, Journal of the autonomic nervous system, 69(2-3), 1998, pp. 164-172
Our aim was to select those parameters of heart rate variability (HRV)
within its short-term power spectral analysis (PSA), which have a cap
ability similar to that of the standard Ewing battery of cardiovascula
r function tests in determining different degrees of cardiovascular au
tonomic neuropathy (CAN) in diabetes and to compare the usefulness of
both methods for diagnostic purposes in the everyday routine. Commonly
used standard battery of cardiovascular autonomic function tests eval
uated as total Ewing score as well as short-term PSA of HRV were used
in 119 diabetic patients (age: 52.7 +/- 9.8, diabetes duration: 2.2 +/
- 12.7 years). From this cohort, patients were selected according to t
he total Ewing score by matching for age, gender, BMI and diabetes typ
e for 3 groups, each of 17 patients, with no CAN (total Ewing score 0-
0.5), with early involvement (score 1.0-2.5) and with definite or seve
re CAN (score 3.0-5.0). Short-term PSA of HRV performed in three posit
ions (supine1-standing-supine2) included frequency-domain and time-dom
ain parameters of HRV. Cumulative spectral power of total frequency ba
nd (0.06-0.50 Hz) and spectral power of low-frequency band (0.06-0.15
Hz) during both supine positions proved to be the most selective and d
iscriminating among all patient groups in inter-group comparison and i
n analysis of discriminance The correlation between the total Ewing sc
ore and the cumulative spectral power of total frequency band was r =
- 0.87 (P < 0.001), About 83.2% of cases classified by short-term PSA
of HRV using the variables selected by analysis of discriminance was c
ongruent with the classification by the total Ewing score alone. Time
expenditure for the performance of each examination was 31 +/- 10 min
for Ewing test battery vs. 14 +/- 2 min for short-term PSA of HRV (P <
0.001). In summary, the latter method showed similar diagnostic value
concerning the CAN as the classical Ewing standard battery of cardiov
ascular function tests, although its application proved to be shorter,
less stressful and more independent from patient cooperation. Cumulat
ive spectral power of total frequency band (LFHF cumpower) can be used
for overall description of the degree of cardiac denervation in diabe
tes while using short-term PSA of HRV. (C) 1998 Elsevier Science B.V.
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